133 articles - From Friday Jan 27 2023 to Friday Feb 03 2023
Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…
| Gut |
| Hepatology |
meta-analyses and systematic reviews
| Aliment Pharmacol Ther |
Meta-analysis: The impact of light-to-moderate alcohol consumption on progressive non-alcoholic fatty liver disease. There is wide heterogeneity in studies on the impact of alcohol on progressive NAFLD. Nevertheless, cohort studies reported a significant harmful effect of moderate alcohol consumption on the occurrence of advanced fibrosis. Further research is needed to make valid recommendations with regard to alcohol consumption in patients with NAFLD. |
| Am J Gastroenterol |
Exercise Training Is Associated With Treatment Response in Liver Fat Content by Magnetic Resonance Imaging Independent of Clinically Significant Body Weight Loss in Patients With Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis. Independent of weight loss, exercise training is 3 and a half times more likely to achieve clinically meaningful treatment response in MRI-measured liver fat compared with standard clinical care. An exercise dose of at least 750 metabolic equivalents of task-min/wk seems required to achieve treatment response. These results further support the weight-neutral benefit of exercise in al patients with NAFLD. |
Systematic Review and Meta-Analysis on the Effects of Lactulose and Rifaximin on Patient-Reported Outcomes in Hepatic Encephalopathy. Patients with HE treated with lactulose or rifaximin reported improvements in important PROs. These results may inform provider-patient communication and help manage patient expectations regarding the potential benefits of HE therapies. |
| Clin Gastroenterol Hepatol |
Efficacy of elimination diets in eosinophilic esophagitis: a systematic review and meta-analysis. Dietary therapy is an effective treatment for EoE patients of any age. The current results could support a trend towards less restrictive dietary regimens as a primary treatment option. |
Food Processing and Risk of Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis. There was no association between risk of UC and ultra-processed foods (HR: 1.17, 95%CI: 0.86-1.61, I2=74%) or unprocessed/minimally processed foods (HR: 0.84, 95%CI: 0.68-1.02, I2=0%). Higher ultra-processed food and lower unprocessed/minimally processed food intakes are associated with higher risk of CD but not UC. |
Prevalence and characteristics of nonalcoholic fatty liver disease and fibrosis in people living with HIV monoinfection: a systematic review and meta-analysis. Our study confirms that the burden of NAFLD, NASH and fibrosis is high among PLWH monoinfection. Prospective longitudinal studies are needed to delineate NAFLD, NASH, and fibrosis risk factors, and identify early interventions and new therapies for NAFLD in this population. |
RCT, clinical trials, retrospective studies, etc…
| Aliment Pharmacol Ther |
Original article: The prognostic value of including non-alcoholic fatty liver disease in the definition of metabolic syndrome. Inclusion of NAFLD allows for identification a greater proportion of the population with metabolic risk. This allows for early intervention and potential to lift some burden off the global healthcare system. |
Randomised clinical trial: Safety, tolerability, pharmacodynamics and pharmacokinetics of zastaprazan (JP-1366), a novel potassium-competitive acid blocker, in healthy subjects. It also showed rapid, potent suppression of gastric acid secretion. Pharmacodynamic and pharmacokinetic profile of zastaprazan was suitable for treatment of patients with acid-related diseases. |
| Am J Gastroenterol |
A prospective study of preemptive tenofovir disoproxil fumarate therapy in HBsAg-positive diffuse large B cell lymphoma patients receiving R-CHOP. Preemptive TDF therapy in HBsAg-positive patients with DLBCL receiving R-CHOP chemotherapy was safe and effective for preventing HBV-related hepatitis. However, a long-term maintenance strategy of preemptive TDF therapy should be recommended because of the relatively high rate of HBV-related hepatitis after withdrawal from TDF (ClinicalTrials.gov ID NCT02354846). |
Application of the Latest Advances in Evidence-Based Medicine in Primary Biliary Cholangitis. These include updates to prognostic models on risk stratification, new noninvasive tools for staging of disease, updates to the appropriate use of and long-term treatment results with obeticholic acid as a second-line treatment, the emerging therapeutic role of fibrates, and the advancement of investigational agents for managing PBC. In this updated expert consensus document, we provide updates on staging, the use of noninvasive prognostic tools, and a treatment algorithm to provide evidence-based and practical tools for clinicians who manage PBC, with the ultimate goal to improve the long-term outcomes for patients with this chronic liver disease. |
COVID-19 Vaccine Effectiveness Against the Omicron Variant in a Veterans Affairs Cohort of Patients With Inflammatory Bowel Disease. The boosted state was associated with a lower risk of SARS-CoV-2 infections and COVID-19-related hospitalization. Efficacy was lower than what has been seen against previous variants and decreased with prolonged duration from the booster. These findings suggest that patients with IBD, especially those who are immunosuppressed, should consider getting a second booster as per Centers for Disease Control and Prevention recommendations. |
Epidemiology and Economic Burden of Acute Infectious Gastroenteritis Among Adults Treated in Outpatient Settings in United States Health Systems. AGE is a common and costly disease affecting adults of al ages and more females than males, including individuals with or without baseline conditions in a hospital-based outpatient setting. C. difficile was the most common pathogen detected. |
Gastroesophageal Reflux Treatment in Infancy Through Young Adulthood. Infant reflux treatments rely heavily on nutritional interventions, whereas reflux in older children is treated more commonly with medications. However, because of the broad differential diagnosis, treatment nonresponse merits a re-evaluation of the diagnosis being treated and additional testing to provide a more precision-medicine approach to care. |
Has the incidence of inflammatory bowel disease peaked? Evidence from the population-based NorDIBD Cohort 1978-2020. Our population-based NorDIBD cohort suggests stabilizing of the incidence of IBD in Denmark, whereas the prevalence continues to rise. As the data represent a 10% sample of the entire Danish IBD population, we believe that data can be extrapolated to the IBD population in general and used for healthcare planning. |
Incidence of hepatic decompensation after nucleos(t)ide analogue withdrawal: Results from a large, international, multi-ethnic cohort of patients with chronic hepatitis B (RETRACT-B study). Patients with cirrhosis and start of therapy HBeAg positive patients should be carefully assessed prior to stopping NAs to prevent hepatic decompensation. Frequent monitoring of viral and host kinetics after cessation is crucial to determine patient outcome. |
Nutrition Literacy Is Not Sufficient to Induce Needed Dietary Changes in Nonalcoholic Fatty Liver Disease. Subjects with NAFLD have poor diet quality despite receiving medical recommendations to lose weight and having nutrition literacy and perception that are comparable with subjects without NAFLD. Educational approaches may not be sufficient to promote weight loss and improve diet quality in NAFLD. |
Short-term and Long-term Outcomes of a Disruption and Disconnection of the Pancreatic Duct in Necrotizing Pancreatitis: A Multicenter Cohort Study in 896 Patients. At least 1 of every 4 patients with necrotizing pancreatitis experience DPD, which is associated with detrimental, short-term and long-term interventions, and complications. Central and subtotal pancreatic necrosis and high levels of serum C-reactive protein in the first 48 hours are independent predictors for DPD. |
The Short-Term Efficacy of Bifidobacterium Quadruple Viable Tablet in Patients With Diarrhea-Predominant Irritable Bowel Syndrome: Potentially Mediated by Metabolism Rather Than Diversity Regulation. A Bifidobacterium quadruple viable tablet had a significant short-term efficacy for the treatment of diarrhea-predominant IBS and was more effective in patients with higher abdominal pain scores. This kind of probiotics could improve the abundance of several bacteria producing SCFAs and the concentration of fecal SCFAs compared with placebos. |
Triglyceride Variability and Risk of First Acute Pancreatitis: a Retrospective Multi-institutional Cohort Study. In this multi-institutional cohort study, high triglyceride variability was associated with an increased risk of first attack of acute pancreatitis, independent of baseline and mean triglyceride levels. The association between triglyceride variability and acute pancreatitis may be partly mediated by subclinical inflammation. |
Withdrawal of long-term nucleotide analogue therapy in chronic hepatitis B: Outcomes from the withdrawal phase of the HBRN immune active treatment trial. Results from this trial do not support TDF withdrawal as a therapeutic strategy. HBsAg loss was infrequent within 2 years of stopping long-term TDF. If withdrawal is considered, HBV DNA should be carefully monitored with reinitiation of therapy if levels rise above 4 log10IU/mL to reduce the risk of ALT flares, as they were not associated with subsequent HBsAg decline or loss. |
Yield of Repeat Endoscopy for Barrett's Esophagus after Normal Index Endoscopy. The yield of repeat EGD for BE/EAC/EGJAC appears to increase with time following a normal index EGD, particularly for younger individuals. Prospective studies are warranted to confirm these findings. |
| Clin Gastroenterol Hepatol |
Adalimumab in biologic-naïve patients with Crohn's disease after resolution of an intra-abdominal abscess: a prospective study from the GETAID. Disease duration (HR=1.32, 95%CI: 1.09-1.59, p=0.008), abscess drainage (HR=5.59, 95%CI: 2.21-14.15, p=0.001), and inflammatory changes in mesenteric fat (HR=0.4, 95%CI: 0.17-0.94, p=0.046) were significantly associated with ADA failure at W104. Provided that the abscess was carefully managed before initiating medical treatment, this study showed the high efficacy of ADA in the short and long term in biologic-naïve patients with CD complicated by an intra-abdominal abscess. |
Comparative Safety of Biologic Agents in Patients with Inflammatory Bowel Disease with Active or Recent Malignancy: A Multi-Center Cohort Study. In patients with IBD with active or recent cancer, TNFa antagonists and non-TNF biologics have comparable safety. Choice of biologic should be dictated by IBD disease severity in collaboration with an oncologist. |
Saroglitazar, A Dual PPAR a/ Agonist, Improves Atherogenic Dyslipidemia in Patients with Non-Cirrhotic Nonalcoholic Fatty Liver Disease: A Pooled Analysis. Saroglitazar improved the serum atherogenic lipoprotein profile in patients with NAFLD, irrespective of co-morbid conditions and statin use. Saroglitazar has the potential to not only positively affect liver disease but also reduce cardiovascular risk in patients with NAFLD. |
The socioeconomic impact of irritable bowel syndrome: an analysis of direct and indirect healthcare costs. Direct costs were not predominantly related to gastrointestinal care, but rather to mental healthcare. Awareness of the nature of costs and contributing patient factors should lead to significant socioeconomic benefits for society. |
| Endosc Int Open |
Comparing size measurement of colorectal polyps using a novel virtual scale endoscope, endoscopic ruler or forceps: A preclinical randomized trial. VSE had significantly higher relative accuracy in measuring polyps compared to ER or BF assisted measurement. VSE improves correct classification of polyps at clinically important size thresholds. |
Sessile serrated lesion detection rates continue to increase: 2008-2020. SSLDR increased steadily and significantly throughout our study period but variance among endoscopists persists. The peak SSLDR from 2020 of 7.94 % should serve as the local aspirational target for this division's attendings and fellows but should be continuously reevaluated. |
| Endoscopy |
Intravenous paracetamol for persistent pain after endoscopic mucosal resection discriminates patients at risk of adverse events and those who can be safely discharged. PPE occurs in approximately 20% of patients and resolves rapidly and completely in the majority with administration of intravenous paracetamol. PPE despite opiates heralds a more serious scenario and further investigation should be considered. |
Risk of total metachronous advanced neoplasia at surveillance colonoscopy after detection of serrated lesions: A matched case cohort study. Patients with SLs are at greater risk for developing T-MAN regardless of synchronous adenomas. Patients with SL and HRA, and those with large or proximal SSLs appear to be at greatest risk for T-MAN. |
The effect of antithrombotic treatment on the fecal immunochemical test for colorectal cancer screening: a nationwide cross-sectional study. The PPV for CRC or high risk adenomas was decreased nearly twofold in patients treated with NOAC (adjusted RR 0.58, 95 %CI 0.51-0.66]). CONCLUSION : Antithrombotic treatment was associated with a decreased PPV in FIT-based CRC screening. |
| Gastroenterology |
Clinical Spectrum and Science Behind the Hamartomatous Polyposis Syndromes. While the malignant potential of hamartomatous polyps remains elusive, timely recognition of these syndromes is important and enables pre-symptomatic cancer surveillance and management prior to symptom exacerbation. Presently, there are no standard agents to prevent the development of polyps and cancers in the hamartomatous polyposis syndromes. |
Controlling Gastric Cancer in a World of Heterogeneous Risk. By contrast, identification and targeted surveillance of individuals with precancerous lesions (such as intestinal metaplasia) is being increasingly embraced in nations of low incidence. This review will also highlight existing knowledge gaps in GC prevention, as well as the role of emerging technologies for early detection and risk stratification. |
Lynch syndrome genetics and clinical implications. At the same time, immunotherapy has revolutionized the treatment of advanced cancers with MMR defects. We aim to review the recent progress in the LS field and discuss how the accumulating epidemiological, clinical, and molecular information have contributed to a more accurate and complete picture of LS, resulting in genotype- and immunological subtype-specific strategies for surveillance, cancer prevention, and treatment. |
Modulating the Microbiome for Disease Treatment. In this review we discuss potential bidirectional interactions between microbes and host, describe the changes in gut microbiota induced by probiotic and prebiotic approaches, and their potential clinical consequences and summarize how to develop a systematic approach to designing probiotics capable of altering the host microbiota in disease states, using Crohn's Disease (CD) as a model chronic disease. Understanding how the effective changes in the microbiome may enhance treatment efficacy may unlock the possibility of modulating the gut microbiome to improve treatment using a natural approach. |
The evolutionary landscape of colorectal tumorigenesis: recent paradigms, models and hypotheses. These include: non-linear and neutral evolution; polyclonality of driver mutations and parallel evolution in adenomas, although only rarely in carcinomas; the ability of mutational processes to shape evolution against the force of selection; the presence of rare driver genes that function in the same signalling pathways as the longstanding canonical drivers; and the existence of selective windows that constrain the functional effects of cancer driver mutations within limits. Many of these nascent evolutionary paradigms are potentially important for treating CRCs as well as understanding their development. |
| Gastrointest Endosc |
Cold snare endoscopic mucosal resection for the removal of large duodenal adenomas. CS-EMR reduces IPB and PPB however it may increase the risk of immediate perforation and is associated with significantly higher rate of recurrence at SE1. Further technical refinements are required to optimize endoscopic resection techniques for DA. |
Endoscopic ultrasound-guided fine-needle biopsy of solid pancreatic tumors with 3 versus 12 to-and-fro movements: A multicenter prospective randomized controlled study. Diagnostic sensitivity and accuracy of EUS-FNB with 3-TAFs were not inferior to those with 12-TAFs for solid pancreatic lesions. The 3-TAFs group showed significantly less blood contamination in sampled tissues than the 12-TAFs group. |
Investigation into the content of red material in EUS-guided pancreatic cancer biopsies. Whether it was red or white material, there was a high concordance of KRAS mutation types (34/40, 85%) and high correlation of mutation allele frequency (=0.66, p<0.001). In EUS FNB, the red material contains a higher amount of tumor DNA, and can be an alternative source for tumor DNA analysis. |
Modified double layered suturing for a mucosal defect after colorectal endoscopic submucosal dissection (Origami method). This new closure method is feasible and recommended. The OGM could achieve reliable closure of large defects in any location, including the proximal colon and thick-walled lower rectum, using only TTSC. |
Risk of post sphincterotomy bleeding with antiplatelet and anticoagulant use - A propensity-matched analysis of United States Collaborative Network. Our database analysis shows that patients on AC and APT are indeed at a higher risk of post sphincterotomy bleeding, compared to matched controls. Appropriate drug cessation period or alternative biliary decompression modalities may be utilized in these patients. |
Safety and Feasibility of Same-Day Discharge After Endoscopic Submucosal Dissection: A Western Multicenter Prospective Cohort Study. Invasive cancer, lesions in the upper GI tract, those associated with longer procedure or performed by low ESD volume endoscopists are more likely to be admitted post-procedurally. Risk stratification of patients for SDD after ESD should help optimize resource utilization and enhance ESD uptake in the West. |
| Gut |
Combining ferroptosis induction with MDSC blockade renders primary tumours and metastases in liver sensitive to immune checkpoint blockade. Our data highlight a context-specific ferroptosis-induced immune response that could be therapeutically exploited for the treatment of primary liver tumours and liver metastases. |
Phenotypic CD8 T cell profiling in chronic hepatitis B to predict HBV-specific CD8 T cell susceptibility to functional restoration in vitro. The possibility to distinguish patient cohorts with different capacity to respond to immune modulatory compounds in vitro by a simple analysis of the phenotypic CD8 T cell exhaustion profile deserves evaluation of its clinical applicability. |
Proton pump inhibitors and the risk of inflammatory bowel disease: population-based cohort study. The results remained consistent in several sensitivity analyses. Compared with H2RAs, PPIs were not associated with an increased risk of IBD, after accounting for protopathic bias. |
Targeting m6A reader YTHDF1 augments antitumour immunity and boosts anti-PD-1 efficacy in colorectal cancer. Importantly, targeting YTHDF1 by CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats) or VNPs-siYTHDF1 boosted anti-PD1 efficacy in MSI-H CRC, and overcame anti-PD1 resistance in MSS CRC. YTHDF1 impairs antitumour immunity via an m6A-p65-CXCL1/CXCR2 axis to promote CRC and serves as a therapeutic target in immune checkpoint blockade therapy. |
| Hepatology |
Primary prophylaxis for spontaneous bacterial peritonitis is linked to antibiotic resistance in the Veterans Health Administration. Among patients who developed their first SBP episode, there was a higher prevalence of antibiotic resistance in those on SBPPr, with a high rate of fluoroquinolone resistance across the Veterans Health Administration sites. |
Rngtt governs biliary-derived liver regeneration initiation by transcriptional regulation of mTORC1 and Dnmt1 in zebrafish. Furthermore, rptor and dnmt1 mutants displayed the same liver regeneration defects as rngtt mutation. In conclusion, our results suggest Rngtt is a new factor that initiates BEC-derived liver regeneration. |
| J Hepatol |
Absent expansion of AXIN2+ hepatocytes and altered physiology in Axin2CreERT2 mice challenges the role of pericentral hepatocytes in homeostatic liver regeneration. We find no evidence of predominant expansion of the pericentral hepatocyte population during liver homeostatic regeneration. Our data highlight the importance of detailed preclinical model characterisation and the pitfalls which may occur when comparing across sexes and backgrounds of mice and the effects of genetic insertion into native loci. |
Hepatitis D virus interferes with hepatitis B virus RNA production via interferon-dependent and -independent mechanisms. Our data indicate that HDV interferes with HBV through both IFN-dependent and IFN-independent mechanisms. Specifically, we uncover a new viral interference mechanism in which proteins of a satellite virus affect RNA production of its helper virus. Exploiting these finding could pave the way to the development of new therapeutic strategies against HBV. Impact and implications Although, the molecular mechanisms remained unexplored, it was known for long that despite its dependency, HDV decreased HBV viremia in patients. Here, using in vitro and in vivo models, we showed that HDV interferes with HBV through both IFN-dependent and IFN-independent mechanisms affecting HBV RNAs metabolism and we defined the HDV-induced modulation signature. The mechanisms we uncovered could pave the way to the development of new therapeutic strategies against HBV by mimicking and/or increasing the effect of HDAg on HBV RNAs and the HDV-induced modulation signature may allow to the draw correlation withthe responsiveness to IFN alpha treatment and thereby ultimately help in the management of HBV/HDV co-infected patients. |
Identification of a tumour immune barrier in the HCC microenvironment that determines the efficacy of immunotherapy. We identified that the TIB structure formed by the interaction of SPP1 + macrophages and CAFs is related to immunotherapy efficacy. Therefore, disruption of the TIB structure by blocking SPP1 may be considered a relevant therapeutic approach to enhance the therapeutic effect of ICB treatment in HCC. Impact and implications Only a limited number of patients with HCC benefit from tumour immunotherapy, which significantly hinders the application of immunotherapy in HCC patients. Here, we used multiomics to identify the spatial structure of the tumour immune barrier (TIB), which is formed by the interaction of SPP1 + macrophages and CAFs in the HCC microenvironment and contributes to immunotherapy efficacy by limiting immune cell infiltration into malignant regions. Preclinically, we revealed that blocking SPP1 or macrophage-specific deletion of Spp1 in mice could destroy the TIB structure and sensitize HCC cells to immunotherapy. These results provide the first key steps towards finding more effective therapies for HCC and have a strong impact on physicians, scientists, and drug developers in the field of HCC. |
Inhibition of VEGF-B signaling prevents non-alcoholic fatty liver disease development by targeting lipolysis in the white adipose tissue. Taken together, our data from mouse models and human subjects suggest that VEGF-B antagonism may represent an approach to combat NAFLD by targeting hepatosteatosis through suppression of lipolysis. Impact and implications NAFLD is a common co-morbidity in type 2 diabetes mellitus (T2DM), and the global prevalence is between 25-29 %. There are currently no approved medicines for treating NAFLD, and given the enormous proportions of the ongoing diabetes epidemics, there is an urgent need to identify new treatment options. Our work suggest that VEGF-B antagonism may represent an approach to combat NAFLD by targeting hepatosteatosis through suppression of lipolysis. The neutralizing anti-VEGF-B antibody, which was used in this study, has already entered clinical trials in diabetic patients. Therefore, we believe that our results are of great general interest to a broad audience, including patients and patient organizations, the medical community, academia, the life science industry and the public. |
Long-term outcomes of patients with type 1 or 2 autoimmune hepatitis presenting in childhood. In terms of liver outcome, type 2 hepatitis is not different from type 1. Withdrawal of treatment is possible without prior liver histology. A persistent abnormal prothrombin ratio identifies patients who will require liver transplantation in adolescence or early adulthood. Impact and implications In children with autoimmune hepatitis, there are conflicting reports on the differences between type 1 and type 2 hepatitis regarding outcome, and on the possibility of treatment withdrawal, before which liver histology is required; data concerning >10-year overall and native liver survivals are limited. In this study we found no differences between types 1 and 2 hepatitis; a durable treatment-free state was achieved in 19% of al patients throughout childhood and early adulthood, and in 45% of children for whom treatment withdrawal was attempted without prior liver histology; prothrombin was found to be predictive of 30-year overall and native liver survivals. The results allow a softer approach to treatment withdrawal in children, avoiding the risks of a liver biopsy, and they provide a tool to help anticipate the need for liver transplantation before complications occur. |
Risk of liver fibrosis associated with long-term methotrexate therapy may be overestimated. Diabetes was the most significant risk factor associated with liver stiffness =7.9 kPa (adjusted OR = 3.19, 95% CI 1.95 - 5.20, P <0.001). Regular use of non-steroidal anti-inflammatory drugs showed the strongest association with ELF =9.8 (OR = 1.76, 95% CI 1.20 - 2.56, P =0.003), suggesting the degree of joint inflammation in RA may confound ELF as a non-invasive marker of liver fibrosis CONCLUSION: The risk of liver fibrosis attributed to MTX itself might have been previously overestimated; there is a need to consider modifying current MTX therapy monitoring guidelines. |
| J Neurogastroenterol Motil |
A Median Arcuate Ligament Syndrome Could Be Re-termed as a Nutcracker Celiac Ganglion Abdominal Pain Syndrome. We suggest renaming MALS as NCGAPS, nutcracker celiac ganglion abdominal pain syndrome, to better explain the mechanism of the recurrent abdominal pain. Further studies on the diagnostic cutoff of clinical and radiological scores of NCGAPS are needed not to miss the diagnosis of NCGAPS. |
| Neurogastroenterol Motil |
Initial assessment of medical post-traumatic stress among patients with chronic esophageal diseases. Preliminary evidence suggests medical PTS affects few patients with esophageal disease. However traumatic procedures, most often associated with HRM, significantly increase PTS symptoms. The potential impacts of medical PTS on esophageal patient assessment and outcomes are considerable and warrants further study. |
Plenty of the editorials are available as full text through the publisher website using the provided link
| Aliment Pharmacol Ther |
| Clin Gastroenterol Hepatol |
| Endosc Int Open |
| Gastroenterology |
| Gut |
Microbial transmission, colonisation and succession: from pregnancy to infancy. In addition, we discuss the possibility of in utero microbial colonisation during pregnancy, which has been highly debated in recent studies, and highlight the importance of the microbiome in infant development during the first 3 years of life. This holistic view of the role of the microbial interplay between mothers and infants will refine our current understanding of pregnancy complications as well as diseases in early life and will greatly facilitate the microbiome-based prenatal diagnosis and treatment of mother-infant-related diseases. |
| J Hepatol |
Hemostasis in cirrhosis: understanding destabilising factors during acute decompensation. This review will outline the latest findings on hemostatic alterations driven by AKI, bacterial infections/sepsis, and ACLF in hospitalised patients with decompensated cirrhosis and provide evidence supporting more tailored management of bleeding risk in these patients. TRIAL REGISTRATION |
misc publications eg case reports, tools of the trade, images of the month, etc…
| Am J Gastroenterol |
| Clin Gastroenterol Hepatol |
| Endoscopy |
| Gastroenterology |
| Gastrointest Endosc |
| Gut |
| Hepatology |
Letters to the editors and authors’ replies
| Aliment Pharmacol Ther |
| Clin Gastroenterol Hepatol |
| Gut |
| J Hepatol |